Blue Cross and Blue Shield of North Carolina - H3449

2019 Medicare Star Ratings*

The Medicare Program rates all health and prescription drug plans each year, based on a plan's quality andperformance. Medicare Star Ratings help you know how good a job our plan is doing. You can use these StarRatings to compare our plan's performance to other plans. The two main types of Star Ratings are:

1. An Overall Star Rating that combines all of our plan's scores.

2. Summary Star Rating that focuses on our medical or our prescription drug services.

Some of the areas Medicare reviews for these ratings include:

• How our members rate our plan's services and care;

• How well our doctors detect illnesses and keep members healthy;

• How well our plan helps our members use recommended and safe prescription medications.

For 2019, Blue Cross and Blue Shield of North Carolina received the following Overall Star Rating from Medicare.

3.5 Stars

We received the following Summary Star Rating for Blue Cross and Blue Shield of North Carolina's health/drugplan services:

Health Plan Services: 3.5 Stars

Drug Plan Services: 3.5 Stars The number of stars shows how well our plan performs.

5 stars - excellent4 stars - above average3 stars - average2 stars - below average1 star - poor

Learn more about our plan and how we are different from other plans at www.medicare.gov.

You may also contact us 7 days a week from 8:00 a.m. to 8:00 p.m. Eastern time at 800-665-8037 (toll-free) or800-922-3140 (TTY).

Current members please call 888-310-4110 (toll-free) or 888-451-9957 (TTY).

*Star Ratings are based on 5 Stars. Star Ratings are assessed each year and may change from one year to thenext.

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Note: Note: Blue Cross and Blue Shield of North Carolina is a HMO plan with a Medicare Contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal.

Non-Discrimination and Accessibility Notice

Blue Cross and Blue Shield of North Carolina(Blue Cross NC) provides:• Free aids and services to people with disabilities to

communicate effectively with us, such as: qualified interpreters and/or written information in other formats (large print, accessible electronic formats, etc.)

• Free language services to people whose primary language is not English, such as: qualified interpreters and/or information written in other languages

If you need these services, contact:Customer ServiceCall: 1-800-665-8037, 1-800-922-3140 (TTY)

Hours: Daily, 8 a.m. to 8 p.m.

If you believe that Blue Cross NC has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file a grievance with:

Blue Cross NC, P.O. Box 2291, Durham, NC 27702 Attention: Civil Rights Coordinator-Privacy, Ethics & Corporate Policy OfficeCall: 919-765-1663, 1-888-291-1783 (TTY)Fax: 919-287-5613E-mail: civilrightscoordinator@bcbsnc.com

You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, the Civil Rights Coordinator-Privacy, Ethics & Corporate Policy Office is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at:

Online: https://ocrportal.hhs.gov/ocr/smartscreen/main.jsfMail: U.S. Department of Health & Human Services

200 Independence Avenue, SW Room 509FHHH Building Washington, D.C. 20201

Call: 1-800-368-1019, 1-800-537-7697 (TDD)Complaint forms are available online at: http://www.hhs.gov/civil-rights/filing-a-complaint/index.html

This notice and/or attachments may have important information about your application or coverage through Blue Cross NC. Look for key dates. You may need to take action by certain deadlines to keep your health coverage or help with costs. You have the right to get this information and help in your language at no cost. Contact:

Customer ServiceCall: 1-800-665-8037, 1-800-922-3140 (TTY)Hours: Daily, 8 a.m. to 8 p.m.

Discrimination is Against the LawBlue Cross NC complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

Blue Cross NC does not exclude people or treat them differently because of race, color, national origin, age, disability or sex.

Blue Cross and Blue Shield of North Carolina is an HMO and PPO plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal.BLUE CROSS®, BLUE SHIELD®, the Cross and Shield Symbols and service marks are marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association.

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Multi-language Interpreter Services

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Blue Cross and Blue Shield of North Carolina is an HMO and PPO plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal.BLUE CROSS®, BLUE SHIELD®, the Cross and Shield Symbols and service marks are marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association.